AP Updated: Wednesday, November 21, 2:18 PM
Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.
Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don’t need treatment, the study suggests.

It’s the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.
But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call “cancer” are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don’t really need.
Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it’s relatively new to the debate over breast cancer screening.

We’re coming to learn that some cancers — many cancers, depending on the organ — weren’t destined to cause death,” said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, “once a woman is diagnosed, it’s hard to say treatment is not necessary.”
He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday’s New England Journal of Medicine.
Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

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" ...ultimately, the man you sleep with is a direct reflection of your character. "

....some women spend more time thinking on what outfit they will wear to the club, than thinking about who is the best man to be father to their children....

AP Updated: Wednesday, November 21, 2:18 PM
Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.
Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don’t need treatment, the study suggests.

It’s the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.
But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call “cancer” are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don’t really need.
Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it’s relatively new to the debate over breast cancer screening.

We’re coming to learn that some cancers — many cancers, depending on the organ — weren’t destined to cause death,” said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, “once a woman is diagnosed, it’s hard to say treatment is not necessary.”
He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday’s New England Journal of Medicine.
Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

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This interesting...I had one about three years ago...I read somewhere it stated that breast cancer among African women is very small...There is a school of thought which suggest wearing of brassiers which retrict the flow of blood could be a cause.. Also constant abortions. I read this somewhere Kemstry..not sure where I can find the link.

This interesting...I had one about three years ago...I read somewhere it stated that breast cancer among African women is very small...There is a school of thought which suggest wearing of brassiers which retrict the flow of blood could be a cause.. Also constant abortions. I read this somewhere Kemstry..not sure where I can find the link.

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I think that is an old wives tale. lol

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" ...ultimately, the man you sleep with is a direct reflection of your character. "

....some women spend more time thinking on what outfit they will wear to the club, than thinking about who is the best man to be father to their children....

My breast cancer was discovered with a mammogram screening. I didn't manifest an easily discoverable tumor. The cancer site was a milk duct located just a scant few millimeters away from my chest wall. No monthly hand palp would have ever worked in my own case because of its location; otherwise, my type of breast cancer was the most common kind--Ductal Carcinoma In Situ, or DCIS, estrogen positive.

I wasn't all that consistent about checking for lumps in my breast each month--by the way, all women should *also* check their underarms monthly for the manifestation of lumps, too, still...

Without that mammogram, there is no way I'd have learned that I had developed cancer *anywhere* in my breast.

It is interesting to me that the article suggests that not all breast cancers are destined to kill anybody, and it makes me want to mention this to my medical oncologist so that I can get his considered opinion about it, but I did notice that the article said nothing about *metastisizing cancers*.

See, I wonder if the lethality of a developing cancer is nil when it involves a particular kind of breast cell (on the one hand), yet should the cancer metastisize to a 'different type of cell' in a different part of the body, would such a cancer spread stick to the same kind of cell as found in the breast? Or would it spread to a different part of the body, but into a different kind of cell?

Here's what I mean:

The human body is made up of 4 different kinds of cells. The human breast is made up of more than one of these cell types. Milk ducts are made up of one kind of cell. The fatty tissue is made up of a different kind of cell. The muscles of the breast is made up of another type of cell. The nipple (for example) is made up of a different type of cell (either the same as *skin* is made up of, but possibly different). I say same as skin, but only for the sake of argument--I actually don't know, as it *could* be made up of two! The nipple has an 'external component to it' (skin) as well as the internal component/s (where the milk duct system is involved). I'm just saying for the sake of argument (please excuse my lack of knowledge, here).

Having said all of that (above), my breast cancer was *initially* diagnosed as Stage 0, estrogen positive. IF MY CANCER HAD NOT SPREAD FROM THE MILK DUCT TO THE FATTY TISSUES IMMEDIATELY SURROUNDING THE MILK DUCT, my cancer would have been diagnosed as STAGE ZERO (that's Stage 0, DCIS, estrogen positive).

So here's what happened to me. I occasionally would remember to do self-examination, but if I forgot to do it, no big deal. When I would remember and then would do my self-exam, I wasn't picking up any changes--no lumps. No change? No fear.

I had both breasts examined via mammogram screening. Left breast was OK; however, I was told that there was some kind of irregularity noticeable in the right breast. I was then forwarded for additional testing. I was referred to an oncology surgeon. A biopsy was performed and on the surgeon's recommendation, I went to the magnetic resonance folks (MRI) for the 3-D *ultra-sound* (what I call it) view. CONFIRMATION.

I was told I had STAGE 0 breast cancer because all tests prior to surgery *were visual and/or blood tests* and didn't indicate any spread of cancer cells. I chose lumpectomy (partial breast removal) + lymphadenectomy (removal of sentinel lymph node under my right arm + the partial removal of an associated lymph node--both being removed to determine if my cancer had/had not metastisized from the milk duct into the lymph system (two different kinds of cell types involved--milk duct, type a (what I'll call them to differentiate for this explanation); lymph cells, type b).

The results of the surgery? I was NOT at Stage 0. I was at Stage 1. The cancer cells had fully involved my milk duct (cell type a), and had gone beyond the milk duct into the fatty tissue immediately surrounding that same milk duct (cell type c). Fortunately for me, it was confirmed that the cancer HAD NOT metastasized into the lymph system (cell type b), though IT DID METASTASIZE into the fatty tissues.

NONE OF THESE DISCOVERIES *were possible* WITHOUT THAT MAMMOGRAM!

When I read and process the nature of the information in the article, I have reason to ask myself 'What if it was the case that I didn't need to subject myself to all of the trouble involved in surviving a cancer diagnosis?

And even if I am wrong for thinking this way, as a present-day post-op cancer survivor, I can't see sense dictating that I would have EVER taken the chance of *not doing mammograms* for the POTENTIAL *life saving results* that such tests offers to women AND men, too, so...

Here's what I think is happening with this article:

A doctor/some doctors are *suggesting* that mammograms are less necessary/less efficacious as diagnostic tools than has been 'assumed', and present-day lead to alot of unnecessary surgeries. SMH, but I think I smell the INSURANCE INDUSTRY's interests lurking *somewhere* in this article.

This is not the first time, recently, that there has been some kind of *noise* raised regarding women and mammograms, though the last time I heard something about this issue, it involved disagreement about the AGE that women should begin to engage in *annual mammogram testing*, so...

For my own reasons, I'd have to disagree with the doctor/s authoring this article, only because I am aware of the risk (danger) of cancer cells metastasizing--from one cancer cell type to a different type.

My breast cancer was discovered with a mammogram screening. I didn't manifest an easily discoverable tumor. The cancer site was a milk duct located just a scant few millimeters away from my chest wall. No monthly hand palp would have ever worked in my own case because of its location; otherwise, my type of breast cancer was the most common kind--Ductal Carcinoma In Situ, or DCIS, estrogen positive.

I wasn't all that consistent about checking for lumps in my breast each month--by the way, all women should *also* check their underarms monthly for the manifestation of lumps, too, still...

Without that mammogram, there is no way I'd have learned that I had developed cancer *anywhere* in my breast.

It is interesting to me that the article suggests that not all breast cancers are destined to kill anybody, and it makes me want to mention this to my medical oncologist so that I can get his considered opinion about it, but I did notice that the article said nothing about *metastisizing cancers*.

See, I wonder if the lethality of a developing cancer is nil when it involves a particular kind of breast cell (on the one hand), yet should the cancer metastisize to a 'different type of cell' in a different part of the body, would such a cancer spread stick to the same kind of cell as found in the breast? Or would it spread to a different part of the body, but into a different kind of cell?

Here's what I mean:

The human body is made up of 4 different kinds of cells. The human breast is made up of more than one of these cell types. Milk ducts are made up of one kind of cell. The fatty tissue is made up of a different kind of cell. The muscles of the breast is made up of another type of cell. The nipple (for example) is made up of a different type of cell (either the same as *skin* is made up of, but possibly different). I say same as skin, but only for the sake of argument--I actually don't know, as it *could* be made up of two! The nipple has an 'external component to it' (skin) as well as the internal component/s (where the milk duct system is involved). I'm just saying for the sake of argument (please excuse my lack of knowledge, here).

Having said all of that (above), my breast cancer was *initially* diagnosed as Stage 0, estrogen positive. IF MY CANCER HAD NOT SPREAD FROM THE MILK DUCT TO THE FATTY TISSUES IMMEDIATELY SURROUNDING THE MILK DUCT, my cancer would have been diagnosed as STAGE ZERO (that's Stage 0, DCIS, estrogen positive).

So here's what happened to me. I occasionally would remember to do self-examination, but if I forgot to do it, no big deal. When I would remember and then would do my self-exam, I wasn't picking up any changes--no lumps. No change? No fear.

I had both breasts examined via mammogram screening. Left breast was OK; however, I was told that there was some kind of irregularity noticeable in the right breast. I was then forwarded for additional testing. I was referred to an oncology surgeon. A biopsy was performed and on the surgeon's recommendation, I went to the magnetic resonance folks (MRI) for the 3-D *ultra-sound* (what I call it) view. CONFIRMATION.

I was told I had STAGE 0 breast cancer because all tests prior to surgery *were visual and/or blood tests* and didn't indicate any spread of cancer cells. I chose lumpectomy (partial breast removal) + lymphadenectomy (removal of sentinel lymph node under my right arm + the partial removal of an associated lymph node--both being removed to determine if my cancer had/had not metastisized from the milk duct into the lymph system (two different kinds of cell types involved--milk duct, type a (what I'll call them to differentiate for this explanation); lymph cells, type b).

The results of the surgery? I was NOT at Stage 0. I was at Stage 1. The cancer cells had fully involved my milk duct (cell type a), and had gone beyond the milk duct into the fatty tissue immediately surrounding that same milk duct (cell type c). Fortunately for me, it was confirmed that the cancer HAD NOT metastasized into the lymph system (cell type b), though IT DID METASTASIZE into the fatty tissues.

NONE OF THESE DISCOVERIES *were possible* WITHOUT THAT MAMMOGRAM!

When I read and process the nature of the information in the article, I have reason to ask myself 'What if it was the case that I didn't need to subject myself to all of the trouble involved in surviving a cancer diagnosis?

And even if I am wrong for thinking this way, as a present-day post-op cancer survivor, I can't see sense dictating that I would have EVER taken the chance of *not doing mammograms* for the POTENTIAL *life saving results* that such tests offers to women AND men, too, so...

Here's what I think is happening with this article:

A doctor/some doctors are *suggesting* that mammograms are less necessary/less efficacious as diagnostic tools than has been 'assumed', and present-day lead to alot of unnecessary surgeries. SMH, but I think I smell the INSURANCE INDUSTRY's interests lurking *somewhere* in this article.

This is not the first time, recently, that there has been some kind of *noise* raised regarding women and mammograms, though the last time I heard something about this issue, it involved disagreement about the AGE that women should begin to engage in *annual mammogram testing*, so...

For my own reasons, I'd have to disagree with the doctor/s authoring this article, only because I am aware of the risk (danger) of cancer cells metastasizing--from one cancer cell type to a different type.

One Love, and PEACE

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So, how is one to know without testing? Maybe they are saying that it should be done once a year>

..

" ...ultimately, the man you sleep with is a direct reflection of your character. "

....some women spend more time thinking on what outfit they will wear to the club, than thinking about who is the best man to be father to their children....

Mammograms are still radiation. To have just one is enough radiation to need to have subsequent one and so on and so on. Not saying they don't save lives. I am saying its ok for women to chose not to have them

So, how is one to know without testing? Maybe they are saying that it should be done once a year>

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If no cancer is found, then it IS recommended that women should have a mammogram done once a year. This is the current standard recommendation.

Only people who are post-op breast cancer patients go thru more mammos per year. Once per year is considered normal for *preventative screening*. Twice a year (minimum) would definitely relate to screenings to circumvent re-development of cancer--which is always possible--and thus is screened for--over a 5 year period, post-op.

Cancer was found in my right breast, but not found in my left breast. All aggressive care that was done after the cancer discovery (surgery, radiation w/no chemo, hormone med therapy) was *targeted* toward minimizing the re-development of cancer in my right breast. Thing is, simply because I developed a cancer in *any breast*, it means that I should view the issue as leaving me at least 'vulnerable' to developing a cancer in my left breast anyhow! For this reason, I continue to have annual screenings of both breasts.

Also, when I say targeting, I mean that the surgery (performed by the surgical oncologist) directly targeted the right breast. The radiation treatments (6 weeks, 5 days per week), which was done by the radiation oncologist, targeted the right breast. Neither the surgical, nor the radiation oncologists paid any attention to the left breast when it came time for aggressive care. The radiation and (mammogram), medical oncologists, however, are VERY important to me, longterm post-op.

My radiation oncologist monitors the results of my post-op mammograms, BOTH breasts. My medical oncologist prescribed the HORMONE meds that I must take over the next 5 years to try to control the *estrogen positive* aspect of my cancer history.

Estrogen positive: The cancer cells that I developed GREW because the growth aspect to those cancer cells *fed* off of estrogen! I'm FEMALE. I produce all kinds of estrogen--even if at a lesser amount because I am post-menopausal! That estrogen, though--it's what makes me female, right? Well, the hormone med that my medical oncologist put me on--named ARIMIDEX--BLOCKS the estrogen receptors on those cancer cells. He also prescribed LOW DOSE aspirin for me to take in tandem with Arimidex. (NOTE: This is what is referred to as HORMONE REPLACEMENT THERAPY or something pre-menopausal women hear about all the time, even if unrelated to cancer treatment therapies). He told me that there was some evidence (50/50 chance) that low dose *enhanced* the efficacy of the Arimidex treatment. END OF SIDEBAR.

But back to what you brought up (scheduling of mammograms):

Post-op mammogram screenings, in my own case, means that both breasts are done once a year (same as for preventative care patients). My own schedule is set up so that both breasts are screened each February--the month that the irregularity was first spotted. The breast that developed cancer, however, is done a second time six months later (re-development prevention screening), or every August.

Mammograms are still radiation. To have just one is enough radiation to need to have subsequent one and so on and so on. Not saying they don't save lives. I am saying its ok for women to chose not to have them

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Hi, Bootzey. I agree with you. I do. I went 11 years (1998 thru early 2010) without submitting myself to mammograms. The dang things are painful. SCARY, especially if the techs think they see something wrong. But also, I became uncertain/unclear about whether or not they were safe because of the radiation worry you mention. Me, too. Just how I felt, all in all.

It wasn't until late January, 2010, that I decided to do one again, and only because my new primary care physician threw a hissy-fit on me when I reported in my new patient application that my mother had died from a metastasized breast cancer in 1993, and that I had not had a mammo since 1998--when I'd had a core needle biopsy done in my LEFT breast because of a suspicious lump. That procedure came up benign, thank goodness, but proceding to that test, too, resulted from a lump found, to a mammogram, to an ultrasound, to a core needle biopsy, to a conclusion of BENIGN fibroid.

My new primary doctor didn't scare me (I did do my breast palp stuff regularly enough IMO), but I thought about breast cancer potential in terms of lumps that I could find myself! What he did do, however, is persuade me that with my family background (breast cancer deaths), that I was taking/had taken unnecessary risks every year that I failed to show up for my mammo exams. So, since the testing site was a 10 minute commute by bus from my house (of all reasons I told myself), I went ahead and had the exam done.

Best decision I ever made. I feel that way (given what then jumped off, medically, in my own case), but still....nobody knows better than I do that such a decision to submit to mammogram testing must appeal to our overall sense that *it is time* (mentally, emotionally, spiritually). Or it's likely a *no go*.

If no cancer is found, then it IS recommended that women should have a mammogram done once a year. This is the current standard recommendation.

Only people who are post-op breast cancer patients go thru more mammos per year. Once per year is considered normal for *preventative screening*. Twice a year (minimum) would definitely relate to screenings to circumvent re-development of cancer--which is always possible--and thus is screened for--over a 5 year period, post-op.

Cancer was found in my right breast, but not found in my left breast. All aggressive care that was done after the cancer discovery (surgery, radiation w/no chemo, hormone med therapy) was *targeted* toward minimizing the re-development of cancer in my right breast. Thing is, simply because I developed a cancer in *any breast*, it means that I should view the issue as leaving me at least 'vulnerable' to developing a cancer in my left breast anyhow! For this reason, I continue to have annual screenings of both breasts.

Also, when I say targeting, I mean that the surgery (performed by the surgical oncologist) directly targeted the right breast. The radiation treatments (6 weeks, 5 days per week), which was done by the radiation oncologist, targeted the right breast. Neither the surgical, nor the radiation oncologists paid any attention to the left breast when it came time for aggressive care. The radiation and (mammogram), medical oncologists, however, are VERY important to me, longterm post-op.

My radiation oncologist monitors the results of my post-op mammograms, BOTH breasts. My medical oncologist prescribed the HORMONE meds that I must take over the next 5 years to try to control the *estrogen positive* aspect of my cancer history.

Estrogen positive: The cancer cells that I developed GREW because the growth aspect to those cancer cells *fed* off of estrogen! I'm FEMALE. I produce all kinds of estrogen--even if at a lesser amount because I am post-menopausal! That estrogen, though--it's what makes me female, right? Well, the hormone med that my medical oncologist put me on--named ARIMIDEX--BLOCKS the estrogen receptors on those cancer cells. He also prescribed LOW DOSE aspirin for me to take in tandem with Arimidex. (NOTE: This is what is referred to as HORMONE REPLACEMENT THERAPY or something pre-menopausal women hear about all the time, even if unrelated to cancer treatment therapies). He told me that there was some evidence (50/50 chance) that low dose *enhanced* the efficacy of the Arimidex treatment. END OF SIDEBAR.

But back to what you brought up (scheduling of mammograms):

Post-op mammogram screenings, in my own case, means that both breasts are done once a year (same as for preventative care patients). My own schedule is set up so that both breasts are screened each February--the month that the irregularity was first spotted. The breast that developed cancer, however, is done a second time six months later (re-development prevention screening), or every August.

One Love, and PEACE

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Or maybe its just focusing on diet, exercise, no stress and proper rest. A healthy life style goes a loooong way

..

" ...ultimately, the man you sleep with is a direct reflection of your character. "

....some women spend more time thinking on what outfit they will wear to the club, than thinking about who is the best man to be father to their children....

Or maybe its just focusing on diet, exercise, no stress and proper rest. A healthy life style goes a loooong way

..

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Do you mean *goes a long way* in terms of avoiding breast cancer altogether? Avoiding *any* cancer altogether? Avoiding *any ill* altogether? Are you strictly talking aftercare of cancer patients?

What of genetic predisposition?

As a post-op breast cancer patient, I'd say there's NO HARM health-wise, in getting into the habit/maintaining the habit of focusing on nutrition value in your diet, consistent pursuit of beneficial exercise, reducing transitory AND longterm sources of stress--to be RUTHLESS about this one on stress--and budgeting all the time you can for proper rest, too.